Publish or Perish: Gaming The Impact Factor

We started Cureus to address the many problems in medical publishing. One of the easy targets is Impact Factor (IF). The Wall Street Journal recently took a closer look at impact-factor ranking and how it is used as a metric for assessing scientific merit.

According to the WSJ, “The impact factor (IF), is routinely used by researchers in deciding where to publish and what to read. It guides promotions, tenure decisions and funding committees around the world, who assume someone publishing in a high-
impact journal must be doing superior work.” – WSJ

The IF has become artificially inflated as the reviewers for high IF journals are expected to critique incoming manuscripts with tremendous scrutiny and be highly selective (read: judgmental?) when it comes to ultimately accepting a manuscript. Hence, high IF journals tend to have their editorial board members (and their students and their close
friends) submit their own works (which of course are accepted). Bias?

The Wall Street Journal points out that “The IF is easily gamed, too. One in five academics in economics, sociology, psychology and business said they had been asked by editors to pad their papers with unnecessary citations to articles in the same journal, according to a study published in Science in February.”

It has become such a nefarious cycle of IF inflation, rejection rate inflation of those who are not “members of the club,” and acceptance rate inflation for those with the secret password for entrance.

The Wall Street Journal continues: “The broader worry is that the once-obscure yardstick is now a ubiquitous tool for assessing scientific merit — a job it wasn’t designed to do, and whose use is open to manipulation.”

Cureus has a star-studded multi-disciplinary international Editorial Board made up of some of the most prolific authors and accomplished practitioners in their specialties, coming together to knock traditional IF on its head and create a system where peer-review is actually done by peers with the sole intention of getting papers out there for the whole world to access. And in the process reviewers are neither killing the manuscripts nor the morales of the authors!

Giving Up Sex For Our Love Affair With iPhone

We all know that we’re a culture obsessed with our cellphones — but, can you really have a special bond with your iPhone?

Results of a recent national survey by TeleNav, Inc. showed respondents’ strong attachment to their iPhones — with one-third of Americans admitting they would be more willing to give up sex for a week than be without their mobile phone, 70% were women.

“Smartphone users were more attached to their devices than were feature phone users, with iPhone users leading the pack.” TeleNav reported.

“In fact, iPhone users were more likely than their Android or BlackBerry counterparts to spend a week without their significant other, exercise or shoes — rather than go a week without their phone.”

But Americans’ physiological connection to smartphones may have more to do with the way our phones create deeply emotional feelings of attachment to our friends, relatives and partners according to professional love expert Helen Fisher, Ph.D., a biological anthropologist with a neurological expertise from Rutgers University and author of the book “Why We Love: the Nature and Chemistry of Romantic Love”.

“There are three distinctly different brain systems for mating and reproduction: sex drive, romantic love and feelings of deep attachment. People would rather give up sex for the weekend than their iPhone because their iPhone gives them feelings of attachment to friends, relatives and partners; to world events and games; and to potential lovers,” Dr. Fisher told Forbes.

“The sex drive is an immediate feeling, intense, but quickly dissipated. [On the other hand], the iPhone can elicit a long, deeply emotional and stimulating connection to a broad world.  Also, emotion is more controlled on the phone, so much so, it offers unconditional love!”

Sex was not the only thing smartphone users were willing to forego — 68% of iPhone users and 65% of Android users would rather go a week without exercise than without a phone.  The study also revealed that 55% of respondents would be more willing to give up caffeine for a week than their mobile phone, 63% would be more willing to give up chocolate, and 70% would be willing to forego alcohol.

What are you willing to give up in exchange for quality time with your smartphone? Be careful what you wish for.

Study Reveals Burnout Among US Doctors At Alarming Level

The widespread problem of Doctor burnout has has been on the forefront of medical news lately after findings from a national survey which included more than 7,000 doctors revealed that nearly half of US physicians struggle with burnout.

“More than four in 10 U.S. physicians said they were emotionally exhausted or felt a high degree of cynicism, or “depersonalization,” toward their patients, said researchers whose findings appeared in the Archives of Internal Medicine.

“The high rate of burnout has consequences not only for the individual physicians, but also for the patients they are caring for,” said Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, who led the research. Source: Reuters

The study also revealed that doctors practicing in specialties at the front line of care including emergency medicine, general internal medicine, and family medicine appear to be at greater risk of burnout.

In this setting, “doctors are losing their inspiration,” Dr. Shanafelt said, “and that is a very frightening thing.” Source: NYT

We talked to our Cureus Editorial Board members about physician burnout — Dr. Johathan S. Weiss, M.D. offered up his insight.

“Given my experience in Academics, burnout occurs due to relatively low pay while working under conditions of high pressure to publish, perform at a high level and produce funding for research.”

Although it’s still not clear why burnout strikes so many doctors — Dr. Shanafelt is convinced that “excessive workloads are only part of the equation”. He cites other possible reasons include “too much paperwork, loss of professional autonomy and a higher patient load to make up for declining reimbursement rates.”

Video Message from Dr. John Adler, MD

Our Founder and Editor-in-Chief, Dr. John Adler, MD introduces the Cureus Editorial Board as well as our new Director of Editorial Operations, Rachel Pollock Wurman, PhD. Enjoy.

httpvh://www.youtube.com/watch?v=BRyUTk29dxU&feature=youtu.be&hd=1

Dara Torres Offers an Olympic Perspective on Medicine

dara torresDara Torres, mother of 6-year old, Tessa, and author of Age is Just A Number, took time from her busy schedule to talk with Cureus about her experiences as a 5-time Olympic swimmer and her perspectives as a vast consumer of medical services.

Many people have asked Dara questions about her swimming career, but Cureus wanted to better understand her experiences with the healthcare system resulting from the stress and strain of training and competing intensely for over 3 decades.
Torres laughed, “this will take a year to answer…I’m serious, I’ve had about 25 surgeries!”

Medicine evolves quickly, and just as an Olympic athlete must stay at the “top of his/her game,” Torres is a quintessential example of how important it is for doctors and surgeons to stay at the “top of their games.”

How? By training! The same way an Olympian trains. And Olympians don’t train on rusty outdated equipment.

• An Olympian trains (and competes) with state of the art tools and methods and equipment. Remember when Olympic swimmers wore just plain bathing suits? Now, no racer hits the water without super-slick highly absorptive, muscle compression/supportive skin suits! These suits are designed to give swimmers the best position in the water and added speed above all.

• Physicians train by learning and practicing, and learning and practicing some more. But for this type of skill mastery, a system needs to be in place that gives doctors that “competitive edge”…by giving them quick access to knowledge that allows them to employ the most up-to-date procedures and innovative techniques. This gives doctors the best position!

That’s where Cureus comes into play. Cureus is that system supporting the physicians racing to touch the wall for a medal finish. Doctors no longer have to read papers that were written 5 years ago from data that were collected 5 years before that. Doctors now have Cureus’ super-slick way of publishing information and getting it out there effectively and efficiently and to everyone!

Torres has dealt with the following surgeries:
Tommy John surgery
• 2 repairs to a deviated septum – which Torres attributes to diving into the water so frequently and with such force. She joked: “Obviously I haven’t done anything to change the shape of my nose.”
• 4 laparoscopies
• a torn ligament repair of the thumb (for hitting the timer on the pool wall so hard to ensure proper recording)
• 3 hand surgeries (nerve repair)
• 5 shoulder surgeries
• 8 bilateral knee surgeries

“As far as my knees go, the most recent surgery was the biggie. It was 2009, about a year after Beijing; I had just finished swimming at World Championships; I couldn’t even walk up and down the stairs. Torres describes her experience HERE.

According to Dara’s surgeon, at the Cartilage Repair Center (CRC) at Harvard Medical School, “Torres had patellar maltracking with cartilage loss on the patella and trochlea groove. Her patella was realigned with a tibial tubercle osteotomy (TTO) and resurfaced on both surfaces with her own laboratory grown cells” via autologous chondrocyte implantation (ACI).” This was a complex reconstructive surgery that required extremely careful post-operative rehabilitation.

Without the cutting edge knee reconstruction detailed above, Torres would not have been able to consider a 6th Olympics, nonetheless come within 9/100ths of a second in the final heat of the US Olympic Trials.

The physical demands on the body for such a long duration of competitive athletics, and at that intensity, are truly incredible. But because of the quick up-to-date access to the latest and greatest medical tools, demanded by an Olympic Athlete, Torres is NOT limping up any more stairs and she IS running and working out as she so desires.

Few of us will compete in athletics at the level Dara has enjoyed, but when it comes to medical care, wants and needs, Torres is just like the rest of us, searching for a highly skilled physician who cares about his/her patients! And since medicine is changing constantly, Cureus is going to make sure the spread of medical knowledge is disseminated at Torres-like speed!

Bridging the Gaps: Integrating the Left and Right Brain!

This week, members of the Cureus team had a chance to chat with Richard Baxter, MD of the Cureus Editorial Board and a leading plastic surgeon based in Seattle, Washington.

Why plastic surgery? It’s the ultimate “integration of the left and right brain,” Baxter says. Initially an art major in college, he combined art, his aptitude for medicine and science, and his belief that “there’s gotta be a better way to do these things!” With this mindset, Baxter sees each patient as a living breathing work of art; leveraging creativity with medicine has “allowed me to be innovative in my practice,” he says.

As a medical journal, we asked Dr. Baxter how he digests the published information out there. “Interesting dilemma,” he replied. “I read the abstracts…” He’s noticed the trend that medicine has become increasingly cross-disciplinary over the years, and says “journal politics and inter-specialty rivalry” has made publishing more difficult. While he had an academic appointment years ago, he has actually been more prolific in private practice than in the past. Why? “Quitting my academic appointment has enabled me to have more unfettered relationships with innovative companies, but as you can imagine there is always more to it.”

Why did Dr. Baxter join the Cureus Editorial Board? 1) He is a self-proclaimed “curious” individual, and 2) because of the major opportunities for Cureus to provide a missing link between the too often disparate worlds of the academics and private practitioners. “The boundaries of specialties are changing,” Baxter says, and Cureus can be that platform to both encourage and reinforce cooperation and collaboration.

Baxter believes information and knowledge need to be more readily available both within specialty, and across specialties, connecting the gap between “hot topics” and “innovation” throughout the medical community as a whole.

With his personal drive for innovation, Baxter became tired of waiting two years or even more for published information to be revealed in a traditional journal, saying, “by this time, the information is stale.” He attends The Emerging Trends Committee of the American Society of Plastic Surgeons which organizes a symposium called “hot topics” in conjunction with the annual meeting. Dr. Baxter is a regular speaker at these 6-hour sessions “for curious minds,” which provide an opportunity to hear something new while it is still in fact new. Publishing is not just for academics anymore; “We should be entrepreneurs and innovators!”

Always looking for ways to innovate, Dr. Baxter has combined his vast knowledge of wine with his medical training to author a book entitled: Age Gets Better With Wine, now in its second edition. Dr. Baxter explores the health benefits of wine, and for all of us who love wine, he presents several more reasons to open up another bottle this evening.

Thank you to Dr. Richard Baxter.